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The following narrative and analysis was prepared in early March, 2000. Later events are recorded in another document.



1. Introduction
1.1. The UT Medical Center Residency Program in Pediatrics
Medical education at the University of Tennessee is the responsibility of the UT Health Sciences Center, founded in 1911 to provide comprehensive training in various medical fields. Each year the Health Sciences Center enrolls some 2000 students in its six colleges: Allied Health Sciences, Dentistry, Graduate Health Sciences, Medicine, Nursing, and Pharmacy.

The UT Health Sciences Center is located primarily on the Memphis campus of the University of Tennessee, but it utilizes other clinical and research facilities including the University of Tennessee Medical Center at Knoxville, comprising UT Medical Hospital and the Graduate School of Medicine. Until February 2000, the Memphis campus was a branch of the University of Tennessee system. In the recent reorganization of the university, the Knoxville, Memphis, and Tullahoma (Space Institute) campuses became nominally a single institution. It is unclear what effect that reorganization will have on other aspects of university structure; for example, the Knoxville and Memphis campuses have each had a Faculty Handbook and a Faculty Senate, but these may in some way be combined.

The College of Medicine operates a three-year residency program in pediatrics at the UT Medical Center at Knoxville. The pediatrics residency program at UT Medical Center was established in 1993 and admitted its first class of residents in 1994. The Department of Pediatrics at UT Medical Center has ten tenured faculty members and several other faculty members (Document 1), and trains eighteen pediatric residents per year (six in each of the annual classes of the residency program).

The training for pediatric residents comprises inpatient and outpatient cases. The Accreditation Council for Graduate Medical Education requires five months of inpatient training out of 33 months of training or 15% of the residency experience (Document 2). In 1999 the average daily inpatient census for pediatric patients at UT Memorial Hospital was 11.6 for the 4-East unit, 23.3 for the intensive care nursery (ICN), 19.9 for the intermediate care nursery (IMCN), and 3.2 for the pediatric intensive care unit (PICU) (Document 3). In the first two months of this year, the average daily inpatient census has been 12.8 for the 4-East unit plus 2.8 for pediatrics observation patients, 24.8 for the intensive care nursery (ICN), 24.0 for the intermediate care nursery (IMCN), and 4.3 for the pediatric intensive care unit (PICU) (Document 4). In addition, there are approximately 18,000 registered outpatients in the pediatric practice.

The pediatric residency program is fully accredited by the Accreditation Council for Graduate Medical Education. A letter from ACGME on November 20, 1996, granted "Full Accreditation" while expressing five concerns which needed to be addressed by November 1997 (Document 5). A letter from ACGME on May 12, 1998 reported that the information submitted was satisfactory and that the program would be resurveyed around October 2001 (Document 6).


1.2. Closure of the UT Medical Center Residency Program in Pediatrics
The faculty in the Department of Pediatrics were informed on January 26, 2000, that the residency program would be discontinued on June 30, 2001 (
Document 7; letters from nine members of the Pediatrics faculty, Documents 8-16; the contemporaneous notes of Professor Loucks, Document 31; and the report of Professor Zimo, Document 32). The explanation given at the time was that the program was expensive and that the training of six pediatric residents per year was unnecessary.

The pediatrics faculty were told that their employment would end when the residency program ended, on June 30, 2001. When the faculty asked about their tenure status, they were told that tenure resides in a program, and that when the program is discontinued tenure disappears also (Documents 8-16). The residents in the classes of 2000 and 2001 will be able to complete their residency training; those who were admitted to the program in July 1999 were told that they would not be able to complete residency training at UT Medical Center.


1.3. Subsequent Events
Faculty in the pediatric residency program at the UT Medical Center at Knoxville approached members of the Faculty Senate at UT-Knoxville to ask for advice and assistance. At its meeting on February 7, the Faculty Senate unanimously approved the following resolution (Documents 17, 18):
Resolved, That the UT Faculty Senate deplores the process used to discontinue the Department of Pediatrics at UT Medical Hospital and urges that the decision be rescinded in order to permit adequate consultation with the faculty of the Department concerning:
   (1) Whether there is an educational basis for the decision;
   (2) Whether there are alternatives to closing the Department;
   (3) Whether there are possibilities for retraining or relocating the faculty in the Department; and
   (4) How the current residents in pediatrics can complete their programs without interruption.
That resolution was communicated to UT President J. Wade Gilley on February 8, 2000, in a letter from Mary E. Papke and Robert W. Glenn, President and President-Elect respectively of the Faculty Senate (Document 19). The letter included references to University of Tennessee and AAUP policies relevant to the discontinuation of the pediatrics program. The opinions of the Senate, and the urgency of an early action to reverse the decision, were also presented to President Gilley in a meeting in his office by Professors Papke and Glenn on February 10, 2000. President Gilley responded at that meeting that graduate medical education was expensive and that he had asked UT-Memphis Chancellor William Rice to respond to the Senate's concerns.

In addition, the president of the Knoxville chapter of AAUP wrote to President Gilley on February 7 expressing concern for principles of governance and due process and requesting that the decision to close the program be explained (Document 20).

On February 24, 2000, Professor Glenn sent an e-mail message to three officers of the UT-Memphis Faculty Senate concerning the discontinuation of the pediatrics residency program (Document 21). Replies that day from Charles Leffler, President of the UT-Memphis Faculty Senate (Document 22), Andrew Kang, President-Elect (Document 23), and Dianne Greenhill, Immediate Past President (Document 24), stated that they were unaware of the matter. Furthermore, the minutes of the meeting of the UT-Memphis Faculty Senate on February 8, 2000, include no mention of the pediatrics residency program (Document 25).

At some time between February 24 and February 29, the officers and chairs of the standing committees of the UT-Memphis Faculty Senate met with Chancellor William Rice. Subsequent to that meeting, Senate President Charles Leffler sent an e-mail message to Professor Glenn addressing issues raised by the pediatrics faculty and by the UT-Knoxville Faculty Senate (Document 26). Also, Chancellor Rice wrote to Senate President Papke and to AAUP chapter president Coddington on February 29 stating that the procedures of the Faculty Handbook had been followed, that efforts would be made to assist first-year residents and to relocate tenured faculty, and that further questions about the matter should be directed to Professor Leffler (Document 30).

The issues raised by the Senate and addressed in part by Professor Leffler and Chancellor Rice are the subject of the next section of this document.


2. Issues
2.1. Was the decision made primarily by the faculty?
   Principles. The UT-Memphis Faculty Handbook anticipates active faculty involvement in decisions concerning the shape of educational programs (Document 27). For example, faculty "must actively participate in the determination of the strategic directions of the campuses and institutes of The University" ( 2.2.3). The general policy is that governance should be "cooperative," "open," "a courteous, free-flowing exchange of information," and "a respectful process that gives increased weight to the opinions of participants who are accountable for the matters under consideration" ( 2.3.1). With respect to the termination of tenured faculty, the Handbook ( 7.1.3) says, "According to the Board's policy, in the case of academic program discontinuance, the termination of tenured faculty may take place only after consultation with the Faculty through appropriate committees of the department, the college, and the Faculty Senate. When termination of a tenured faculty appointment is based upon discontinuance of a program or function at UT Memphis, the Administration shall seek appropriate faculty discussion in arriving at such decisions ..." (Document 28). The latter statement is derived from the UT Board of Trustees' revision of tenure policies in June 1998: "In the case of academic program discontinuance, the termination of tenured faculty may take place only after consultation with the faculty through appropriate committees of the department, the college, and the Faculty Senate" (Document 29). AAUP's "Recommended Institutional Regulations on Academic Freedom and Tenure" require a higher standard than consultation; they require that the decision to discontinue a major academic program be made primarily by the faculty: "The decision to discontinue formally a program or department of instruction will be based essentially upon educational considerations, as determined primarily by the faculty as a whole or an appropriate committee thereof" (Document 19b).

The Faculty Handbook ( 2.2.1) says that decisions to "determine new or revised programs to be offered relating to instruction, research, and service" are reserved to the Board of Trustees (Document 27a). But the university has apparently taken the position that the decision to close the residency program and to terminate the faculty in the Department of Pediatrics does not require approval by the UT Board of Trustees. Dr. William E. Blass has been a member of the UT Board of Trustees since July 1999 and also is Professor of Physics and past president of the UT Faculty Senate. Dr. Blass reports that during his tenure on the Board of Trustees there has been, as far as he knows, no consideration of the Pediatrics program. Furthermore, Dr. Blass reports that he has been informed that Board action is unnecessary since the decision concerns elimination of a residency program, not a degree program.

   Facts. The evidence is clear that the faculty did not participate in the decision to close the pediatrics residency program. Letters from the faculty in the program include these statements:
Professor Pablo: "There was no consultation with the faculty concerning the decision whether or not to close the department prior to the announcement of the decision" (Document 8).

Professor Mohr (who is Director of the Pediatric Residency Program): "I was not consulted concerning this decision to discontinue the program. I was not given a chance to discuss options that could have been pursued to maintain a viable program. I was not asked what were the minimum faculty and educational requirements needed to be fully accredited" (Document 9).

Professor Malagon-Rogers: "This decision was not consulted with anybody in the department and no input was taken about it from anybody as to what other options there could be" (Document 10).

Professor Zimo: "There was no consultation with the faculty concerning the decision to close the department, either before or after the announcement of the decision" (Document 11).

Professor Jocher: "There was no consultation with the faculty concerning the decision to close the department, either before or after the announcement of the decision" (Document 12).

Professor Coullahan: "There was no hint that a closing was being discussed and no one ever talked to me, a faculty member, about such a plan. On the contrary, since we were told to continue to interview and recruit future students (residents) I assumed that the University recognized our value and importance. Suddenly, in the midst of the time consuming and expensive (for both the University and the prospective student) recruiting process, we were told without any advance warning that we were no longer needed or wanted. I was also amazed that our department faculty never had the opportunity to review the reasons and preplanning on this decision which seems to have been made without consideration for what our futures will hold" (Document 13).

Professor Lucas: "I am not aware that any consultation with myself or any of the other pediatric faculty at the University of Tennessee Medical Center at Knoxville occurred prior to the announcement of the decision" (Document 14).

Professor Gengozian: "I am not aware of any discussion or prior information given the faculty of this impending action" (Document 15).

Professor Loucks: "Needless to say, in violation of the university faculty handbook and national AAUP guidelines, there was absolutely no consultation with the faculty before the decision was made or announced as to whether or not to close the department or the residency program. The departmental chairman stated in the meeting that he was not expecting for the department or the residency program to be closed and had no foreknowledge of this decision other than thirty minutes before the general meeting" (Document 16).
Furthermore, e-mail messages indicate that as late as February 24 the officers of the UTM Faculty Senate were unaware of the announcement that the pediatrics program was being closed (Documents 22-24). The UTM Faculty Senate leadership was consulted approximately a month after the decision was announced (Document 26), and appear to have given their assent to the decision, but they plainly had no role at all in making the decision.


2.2. Was the decision based essentially upon educational considerations?
   Principles. Neither the tenure policy statement of the UT Board of Trustees (
Document 29) nor the UTM Faculty Handbook (Document 27) states criteria for discontinuation of a major academic program. AAUP's "Recommended Institutional Regulations on Academic Freedom and Tenure" require that the decision to discontinue a major academic program be made primarily on educational grounds: "The decision to discontinue formally a program or department of instruction will be based essentially upon educational considerations, as determined primarily by the faculty as a whole or an appropriate committee thereof. [NOTE: 'Educational considerations' do not include cyclical or temporary variations in enrollment. They must reflect long-range judgments that the educational mission of the institution as a whole will be enhanced by the discontinuance.]" (Document19b).

   Facts. The evidence is clear that the decision to close the pediatrics residency program was based primarily on financial, not educational, considerations. The program is fully accredited by the Accreditation Council for Graduate Medical Education (Document 6). The faculty in the Department of Pediatrics testify to the educational strength of the program:
Professor Pablo: "The program has solid academic credentials so that the decision to close the program and department was not based on an academic rationale, i.e. the program is nationally accredited" (Document 8).

Professor Mohr: "In 1996 the program underwent a routine site visit and received full accreditation for five years (the maximum given to pediatric residencies). Since the inception of the program we have been successful in attracting quality residents. All of our graduates have been able to find pediatric practices in communities of their choice or have gone on to prestigious fellowships for post graduate training. This year, two of our residents were selected to present posters at national meetings. Ninety-two percent of our graduates are board certified. This number is well above the Residency Review Committee requirements" (Document 9).

Professor Malagon-Rogers: "Academically the department is in good standings, and it is fully accredited at the national level. Our graduates have all been employed and are serving an important population of children in several parts of the country" (Document 10).

Professor Zimo: "The program has been accredited, and there has been no suggestion that the quality of the academic program factored into the decision to close the program" (Document 11).

Professor Jocher: "The program has been accredited, and there has been no suggestion that the quality of the academic program factored into the decision to close the program" (Document 12).

Professor Coullahan: "I joined this faculty after interviews with many of the leaders of the Graduate School of Medicine based on their continued reassurance that the Department was strong, was fully supported, and had a long and bright future ahead. I specifically asked about ten years of faculty work and was told that the Pediatric Department was here to stay.... [O]ur faculty has continued to work hard at maintaining the level of excellence that was validated by our five-year accreditation" (Document 13).

Professor Lucas: "I am not aware that the pediatric residency program is on probation or has any deficiency. Therefore, it would have solid academic credentials to that the decision to close the program and department was not based on an academic rationale" (Document 14).

Professor Gengozian: "I certainly know of no academic shortcomings of the Pediatric faculty which would warrant any consideration of a departmental closure let alone the execution of this step" (Document 15).

Professor Loucks: "The pediatric primary care-oriented residency training program has received full accreditation for five years from the American Council of Graduate Medical Education, the national review agency for all residency programs in medicine. What I find even more astounding is that in this era when primary care is emphasized and the most lucrative arena of reimbursement in medical education is primary care, our program is being closed. I can discern absolutely no educational reason for doing so" (Document 16).
It may be that the UT administration will assert post facto an educational basis for the decision to close the program. The president of the UTM Faculty Senate says on the basis of their late consultation with UTM Chancellor Rice, "He [Rice] indicated that a primary reason for discontinuing this department involved the very low patient population (average census of six in University Hospital last year).... No one could disagree that on both academic and financial grounds the patient population is inadequate for a viable residency program" (Document 26). In fact, the average daily census for 1999 is several times higher than what the UTM Faculty Senate was told (Documents 3, 4); and those census figures report only inpatient cases which constitute just 15% of the residency training program in pediatrics.

That the closing of the pediatrics program was based primarily on financial considerations is indicated in the remarks of Chancellor Rice to the faculty on January 26, as recorded in contemporaneous notes (Document 31). Also, at the time the decision was announced, Chancellor Rice said to the reporter for the Knoxville News-Sentinel, "Funding for graduate education ... has been reduced to the point where all teaching hospitals are under financial stress." "It's just a matter of not being able to afford it anymore" (Document 7).
2.3. Were the affected faculty members offered relocation or retraining?
   Principles. The UTM Faculty Handbook ( 7.1.3) says, "When termination of a tenured faculty appointment is based upon discontinuance of a program or function at UT Memphis, the Administration shall ... exert every effort to make suitable reassignments of personnel.... According to the Board's policy, if termination of tenured faculty positions becomes necessary because of financial exigency or academic program discontinuance, the UT Memphis Administration shall attempt to place each displaced tenured faculty member in another suitable position. This does not require that a faculty member be placed in a position for which he or she is not qualified, that a new position be created where no need exists, or that a faculty member (tenured or non-tenured) in another department be terminated in order to provide a vacancy for a displaced tenured faculty member" (Document 28). AAUP's standards also require relocation wherever possible: "Before the administration issues notice to a faculty member of its intention to terminate an appointment because of formal discontinuance of a program or department of instruction, the institution will make every effort to place the faculty member concerned in another suitable position. If placement in another position would be facilitated by a reasonable period of training, financial and other support for such training will be proffered" (Document 19b).

   Facts. The pediatrics faculty report that no efforts have been made to relocate them in other academic positions:
Professor Pablo: "There was no offer to relocate the faculty as faculty within the university system" (Document 8).

Professor Mohr: "At the January 26, 2000 meeting we were told that when the residency was terminated the pediatric academic department would also be disbanded. There was no discussion of alternative faculty opportunities. We were told we would receive letters confirming the termination of our employment" (Document 9).

Professor Malagon-Rogers: "As faculty members, many like me, with Tenure, were not offered any opportunities for relocation with the system ..." (Document 10).

Professor Zimo: "There was no offer to relocate the faculty within the university system. We were bluntly told that, since we were being given 18 months notice, no severance package would be offered" (Document 11).

Professor Jocher: "There was no offer to relocate the faculty within the university system. We were bluntly told that, since we were being given 18 months notice, no severance package would be offered" (Document 12).

Professor Coullahan: "No attempt to reassign us as faculty was discussed" (Document 13).

Professor Lucas: "As a full-time faculty member since 1985 with a sub-specialty in pediatric critical care, I have not been a part of any discussion or received any offers to relocate as faculty with the university system. Neither have any discussions occurred to utilize any other degrees and expertise in any other colleges within the university system" (Document 14).

Professor Gengozian: "Among the responses given to questions raised by the faculty, it was revealed that tenured members would also be summarily dismissed, i.e. lose their positions without any attempt by the University to offer them relocation within the University ..." (Document 15).

Professor Loucks: "With regard to the faculty, at no time before, then, or since has anyone approached me about alternative academic placement although I am qualified to teach in several other academic departments of the graduate school of medicine. There was no offer at the meeting to relocate faculty within the university system. The university's teaching hospital has been leased to a private group last summer and some of our faculty may choose to give up their academic careers and seek employment through the auspices of the hospital. However, even this possibility was not addressed" (Document 16).
It should be noted that the leadership of the UTM Faculty Senate were told that efforts are being made to relocate the faculty and that the administration hopes that no faculty will be terminated: "The extensive effort at present is to ... find positions for the tenured faculty of the department. According to our handbook the only required consultations with faculty senate would be if a tenured faculty member was terminated due to elimination of a department. We hope that situation does not arise" (Document 26). The Pediatrics faculty themselves state that they were informed that the decisions to terminate them were final and that they were not offered alternative academic positions.


2.4. Were the affected faculty members offered an avenue of appeal to a faculty grievance committee?
   Principles. The UTM Faculty Handbook ( 7.1.3) apparently does not anticipate that termination of a faculty appointment due to discontinuation of an academic program--even when the faculty member has tenure--can be appealed through established grievance procedures: "Extraordinary circumstances warranting termination of tenure may involve either financial exigency or academic program discontinuance. Under such circumstances, termination of a faculty member's tenure results in immediate termination of that individual's employment with UT Memphis" (Document 28). AAUP's recommended institutional regulations include provision for grievance proceedings: "A faculty member may appeal a proposed relocation or termination resulting from a discontinuance and has a right to a full hearing before a faculty committee" (Document 19b).

   Facts. The faculty in the Pediatrics Department were not offered recourse to grievance proceedings:
Professor Pablo: "Faculty were not offered recourse to establish[ed] university grievance procedures"(Document 8).

Professor Mohr: "We were not offered recourse to established university grievance procedures" (Document 9).

Professor Malagon-Rogers: "As faculty members, many like me, with Tenure were not offered ... any recourse to establish[ed] university grievance procedures" (Document 10).

Professor Zimo: "Faculty members were not informed that there was any grievance procedure available" (Document 11).

Professor Jocher: "Faculty members were not informed that there was any grievance procedure available" (Document 12).

Professor Coullahan: "We were told that the decision was final. This was interesting to me because of my long Navy career. We always were kept fully informed by Naval authorities and allowed to exercise grievance procedures when closings or terminations were being contemplated. I always assumed that state and University governments would exercise the same due process" (Document 13).

Professor Lucas: "It is my understanding that this was a final decision that involved the dean, the associate dean, and the vice-president for health affairs. Thus any recourse for university grievance procedures did not exist in this particular matter" (Document 14).

Professor Loucks: "There was no hint nor information given concerning university grievance procedures as part of this meeting or thereafter" (Document 16).

2.5. Did the institution exercise due diligence in its responsibilities to students admitted to the pediatrics residency program?
   Principles. The online site for the UT-Memphis Pediatrics Residency Program has a publicity brochure which says at one point, "You are in the process of choosing your Pediatric or Internal Medicine/Pediatric residency, one of the most important decisions in your career as a physician" (http://www.utmem.edu/peds/peds3.html). Given the gravity of the decision, it follows that an institution should treat with professional respect the students whom it recruited and who have a career investment in the program.

   Facts. It is clear that the pediatrics residents have not been treated with professional respect. The first-year residents need to change institutions in order to complete their training. As Professor Mohr, Director of the Pediatric Residency Program, says, "... six first year residents are presently searching for the few second year positions available in the country. This has had a deleterious effect on their work and learning" (Document 9). Professor Loucks' statement is poignant:
"With regard to the pediatric residents who moved to this area, one or two of which brought spouses and bought homes planning on staying in this community throughout residency training and thereafter, they were told in the meeting by Mr. Rice that the university system could absorb them in the remaining programs in Memphis or Chattanooga. When the residents called these programs the next day, they were told that Mr. Rice had just slashed one million dollars from the pediatric teaching hospital, LeBonheur's budget and that they would not be taking on any new residents. Chattanooga's program also held out no hope. Thus, the promised help did not come to these trainees in any form. As a faculty member I feel abashed that I engaged actively, both as a faculty member and Associate Program Director, in the process of recruiting these residents only to have them devastated by the unexpected and untimely closing of the program. One of the residents broke down and sobbed throughout the meeting which took place with them immediately after the faculty meeting" (Document 16).
It should be added that second- and third-year residents will complete their training in a fractured and depleted department, and that the faculty--not having been told that the program was about to be closed--had by the time of the January 26 announcement nearly completed interviewing 35 medical school seniors who had traveled to Knoxville at their own expense to visit the program in preparation for the national match.


3. Conclusion

As the UTK Faculty Senate said on February 7, the decision-making process in the matter of the pediatrics residency program was deplorable, an egregious violation of basic principles of shared governance and due process. The appropriate course, as recommended by the Senate, would be to rescind the decision, make whole the faculty and students who have been harmed, and investigate mechanisms which will restore collegial, shared decision making to the University of Tennessee.





Document 1

Department of Pediatrics
Faculty
1999-2000

[Names in Bold are faculty with tenure.]

Chairman
Eddie S. Moore, M.D.
Program Director
Patricia A. Mohr, M.D.
Associate Program Director
Sandra Loucks, Ph.D.
Clerkship Director
Myrna Pablo, M.D.
Director, Graduate Doctoral Training--
Behavioral Sciences
Sandra Loucks, Ph.D.
Section of Adolescent/Sports Medicine
J. Donald Coullahan, M.D., Director
Humberto Rodriguez, M.D.
Division of Allergy-Immunology (Clinical)
Jeffrey Schlactus, M.D., Director
Anesthesiology Coordinator
Jerry Epps, M.D., Director
Division of Behavioral Pediatrics
Sandra Loucks, Ph.D., Director
Edwin Rogers, Ph.D.
Division of Cardiology (Clinical)
Jeffory Jennings, M.D., Director
Michael Liske, M.D.
Section of Chronic Diseases
Deborah Zimo, M.D., Director
Division of Clinical Pharmacy
Pamela Smith, D.Ph., Director
Section of Medical Ethics (Clinical)
James Nelson, Ph.D.
Division of Critical Care Medicine
Richard Metz, M.D., Director
Matthew Hill, M.D.
Division of Emergency Medicine
Robert Dickson, M.D., Director
Jerry Davitz, M.D.
Timothy Gunter, M.D.
Russell Rhea, M.D.
Division of Endocrinology
ETCH (?Effective 7/1/2000)
Division of Gastroenterology
Jayshree V. Ganatra, M.D., Director
Scott M. Sirlin, M.D. (V)
Division of General Pediatrics
Patricia A. Mohr, M.D., Director
J. Donald Coullahan, M.D.,
Camilla Jocher, M.D.
Saroj Mehta, M.D.
Myrna Pablo, M.D.
Larry Rodgers, M.D.
Deborah Zimo, M.D.
Melinda Lucas, M.D.
Thomas Lester, M.D. (Emeritus)
Division of Genetics-DevelopmentaI Pediatrics
Carmen Lozzio, M.D., Director
Ilse Anderson, M.D.
Virginia Frye, Ed.D.
Carla Matteson, Ph.D.
Division of Hematology-Oncology (Clinical)
Ray Pais, M.D., Director
Victoria Castenada, M.D.
Shahid Matik, M.D.
Division of Infectious Diseases
Pisespong Patamasucon, M.D., Director
Thomas Smith, M.D.
Division of Neonatology
Vichien Lorch, M.D., Director
Mark E. Anderson, M.D.
Tara Burnette, M.D.
Mark S. Gaylord, M.D.
Hanumiah Suvarnamma, M.D.
Kelly Wright, M.D.
James Schmid, M.D. (V)
Division of Nephrology
Maricarmen Malagon, M.D., Director
Eddie S. Moore, M.D.
Division of Neurology (Clinical)
Christopher Miller, M.D., Director
Karsten Gammeltoft, M.D.
Pediatric Ophthalmology
Gary N. Gitschlag, M.D.
Pediatric Orthopedics
Robert R. Madigan, M.D.
Cameron Sears, M.D.
Pediatric Otolaryngology
Joe Graves, M.D.
John Little, M.D.
Pediatric Pathology Coordinator
Frances Patterson, M.D.
Pediatric Physiatry-Rehabilitation
Miriam Weinstein, M.D.
Division of Pulmonology
Vincent McCarthy, M.D., Director
Pediatric Radiology Coordinator
Kenneth Rule, M.D.
Division of Pediatric Research
Nazareth Gengozian, Ph.D.
Division of Pediatric Surgery
Howard Filston, M.D.
Patrick Bailey, M.D.
Pediatric Urology
Preston Smith, M.D., Director
David Riden, M.D.
Voluntary Clinical Faculty
Syed Akhter, M.D.
Robert L. Barnes, III, M.D.
Lori A. Baxter, M.D.
Joe W. Black, III, M.D.
Monica Black, M.D.
William G. Byrd, M.D.
Tommy E. Collins, Jr., M.D.
Clay G. Crowder, M.D.
David Eakes, M.D.
Neil Feld, M.D.
Sarah E. Mason Gilley, M.D.
Richard Glover, M.D.
William E. Harrison, M.D.
Shahid Hasnain, M.D.
William M. Hicks, M.D.
Cecil B. Howard, M.D.
Maria Javier, M.D.
Donald E. Larmee, M.D.
Timothy Lorenz, M.D.
Jill A. McDowell, M,D.
Carla P. McKeethran, M.D.
Foy B. Mitchell, M.D.
Joseph N. Peeden, Jr., M.D.
Wilson L. Powers, M.D.
Henry H. Pride, M.D.
Charles A. Raper, M.D.
Ronald L. Rimer, M.D.
John C. Rochester, M.D.
Janet Rush, M.D.
Alex Ruth, M.D.
William F. Terry, M.D.
Timothy W. Thurston, M.D.
James W. Wall, M.D.




Document 2

Date: Thu, 2 Mar 2000 15:53:43 -0500 (EST)
From: Sandra Loucks
To: "Robert W. Glenn"
Subject: Inpatient Census and Outpatients

Dear Bob,

I am writing to give you some information which may be helpful in understanding the adequacy of our training offered pediatric residents in our program. It is important that you know that the ACGME requires only five months out of a possible 36 month program in a general inpatient pediatric setting. Figured on a 33 month basis (3 months vacation), the general inpatient training requirement represents only 15% of the overall program. Nevertheless, our patient volume and diagnostic range has been deemed adequate by the ACGME.

In contrast, the requirement for ambulatory pediatric training is that of at least 50% of training experiences. We have a registered outpatient, ambulatory patient base of 18,000 patients, not including our community-based pediatric practices, an excellent patient volume.

Thank you - Sandra

Sandra Loucks, Ph. D., ABPP 423-544-9327
Professor and Director, email sloucks@utk.edu
Division of Behavioral- fax 423-544-8879
Developmental Pediatrics UTMC-K
1924 Alcoa Hwy
Knoxville, TN, 37920




Document 3

05-Jan-00 THE UNIVERSITY OF TENNESSEE MEMORIAL HOSPITAL
ADJUSTED CENSUS -- COMBINED IP AND OP BED AVERAGE FY99


UNIT -- PROJECTED
BEDS
PER UNIT
Projected
Census
1999
AUG
1999
SEPT
1999
OCT
1999
NOV
1999
DEC
1999
Y-T-D
DECEMBER
% Occ to Projected
YTD AVG
% Occ to Projected
4 EAST (E20-6241) 28 15.0 11.9 12.1 13.0 11.9 9.3 11.6 62% 78%
ICN (E20-6235) 27 21.4 25.3 25.6 19.7 22.6 23.4 23.3 109% 109%
IMCN (E20-6236) 28 21.6 22.8 23.0 19.1 16.7 17.6 19.9 82% 92%
PICU (E20-6240) 7 4.4 3.4 4.0 3.7 2.9 1.8 3.2 41% 73%





Document 4

UHS: BUSINESS INDICATORS -- 2000


Average Daily Census
Actual
02/28/2000
Budget
02/28/2000
Actual Avg.
Feb-to-Date
Budget Avg.
Feb-to-Date
Actual Avg.
YTD
Budget Avg.
YTD
Nursing Units:
4 EP -- Pediatrics (27 Beds) 16.0 12.4 15.2 12.4 12.8 12.4
4 EP -- Pediatrics [Observation] 2.0 3.1 3.3 3.1 2.8 3.1
Special Care Units:
PICU (7 Beds) 5.0 4.2 4.5 4.2 4.3 4.2
Nursery:
ICN (27 Beds) 23.0 22.1 25.7 22.1 24.8 22.1
IMCN (26 Beds) 28.0 21.6 22.8 21.6 24.0 21.6





Document 5

ACGME

Accreditation Council
for Graduate Medical
Education


515 N. State St., Suite 2000
Chicago, IL 60610
(312) 464-4920
FAX: (312) 464-4098


November 20, 1996

Patricia A. Mohr, MD
Director, Pediatrics Residency Program
University of Tennessee Graduate School of Medicine
1924 Alcoa Highway
Knoxville, TN 37920

Dear Dr. Mohr:

The Residency Review Committee for Pediatrics, which is composed of representatives of the American Academy of Pediatrics, the American Board of Pediatrics and the AMA Council an Medical Education, has reviewed the information submitted regarding the following residency program,
Pediatrics

University of Tennessee Medical Center at Knoxville Program
    University of Tennessee Graduate School of Medicine
    University of Tennessee Memorial Hospital
Knoxville, TN

Program 3204721396
Based on all of the information available to it at the time of its recent meeting, the Residency Review Committee accredited the program as follows:
Status: Full Accreditation
Length of Training: 3
The Committee expressed concern about the following:
1. Goals & Objectives: Written goals and objectives are not available for many of the required components of the program.

2. Surgical Experience: Although the program information form listed 327 admissions an the surgical service, the program director was unclear about the source of these figures. The Committee was unable to determine whether residents have adequate experience.

3. Faculty Research: There is minimal financial support available for faculty participation in research.

4. Evaluation: Sufficiently formal mechanisms for evaluation of the faculty have not yet been developed.

5. Facilities: The facilities that are available to the residents appear marginal. Residents should have access to a complete library in their learning center. In addition, there appears to be insufficient workspace available to the residents.
A progress report in requested in approximately one year in which each of those points should be addressed. This information is requested in triplicate by November 1, 1997. After reviewing this report, the Committee will determine the time of the next survey and review of the program.

It is the policy of the ACGME and of the Residency Review Committee that each time an action in taken regarding the accreditation status of a program, the residents must be notified.

This office must be notified of any major changes in the organization of the program, including discontinuation of rotations to participating institutions, as well as changes in leadership. When corresponding with this office, please identify the program by number and name as indicated above.


Sincerely yours,

Mary Alice Parsons
Executive Director
Residency Review Committee for Pediatrics
(312) 464-4947


CC:   American Medical Association
The American Board of Pediatrics
The American Academy of Pediatrics
Michael R. Caudle, MD
Gene Hall
Robert L. Summitt, MD
Charles J. Fagan, MD
Jo Ann Cornelius





Document 6

ACGME

Accreditation Council
for Graduate Medical
Education


515 N. State St., Suite 2000
Chicago, IL 60610
(312) 464-4920
FAX: (312) 464-4098


May 12, 1998

Patricia A. Mohr, MD
Director, Pediatrics Residency Program
University of Tennessee Graduate School of Medicine
1924 Alcoa Highway
Knoxville, TN 37920

Dear Dr. Mohr:

The Residency Review committee for Pediatrics, which in composed of representatives of the American Academy of Pediatrics, the American Board of Pediatrics and the AMA Council on Medical Education, has reviewed the information submitted regarding the following residency program:
Pediatrics

University of Tennessee Medical Center at Knoxville Program
    University of Tennessee Graduate School of Medicine
    University of Tennessee Memorial Hospital
Knoxville, TN

Program 3204721396

Approximate Date of Next Site Visit: 10/2001 FS

The Committee acknowledged receipt of the report with appreciation and considered it satisfactory.
The program will be resurveyed in approximately three and a half years.


Sincerely yours,

Mary Alice Parsons
Executive Director
Residency Review Committee for Pediatrics
(312) 464-4947


CC:   American Medical Association
The American Board of Pediatrics
The American Academy of Pediatrics
Michael R. Caudle, MD
Gene Hall
Robert L. Summitt, MD
Jo Ann Cornelius





Document 7

Plans to 'phase out' UT's pediatric residency program

Knoxville News-Sentinel, January 31, 2000

By Add Seymour Jr., News-Sentinel staff writer

The University of Tennessee will phase out its pediatric residency program during the next 18 months, according to officials.

Limited funding and an abundance of similar programs within the state led to the decision, UT officials said.
Phasing out the program will allow some of the 18 students in the three-year program to finish their training. Others will have time to transfer, according to UT officials.

William Rice, UT's vice president of health affairs, said the move has nothing to do with UT's current efforts to streamline university functions.

"Funding for graduate education, through TennCare graduate medical education funding and through Medicare, has been reduced to the point where all teaching hospitals are under financial stress," Rice said.

Rice said no other divisions within the College of Medicine and the Graduate School of Medicine in Knoxville are slated to be eliminated, but other divisions across the state are being examined.

"We are downsizing graduate medical education, really across the state" he said, "but we don't think the loss of six additional pediatricians would really have a negative impact on Tennessee.

"It's just a matter of not being able to afford it anymore," Rice said.

Dr. Michael Caudle, dean of the UT Graduate School of Medicine, said other pediatric training programs -- in Nashville, Chattanooga, Johnson City and Knoxville -- would be able to take up the slack.

"The continued aging of our population has made it necessary for us to evaluate the size and scope of our programs to best serve that population segment," Caudle said.

The University of Tennessee Medical Center, which is now privately run by University Health Systems, will continue to provide pediatric services.

Add Seymour Jr. can be reached at 865-342-6312 or seymourA@knews.com.




Document 8


February 24, 2000

To Whom It May Concern:

On behalf of my fellow faculty members of the Pediatric Department at the University of Tennessee Medical Center at Knoxville, I would like to add my voice in making it known that I am of the opinion that the decision to eliminate the whole academic Department of Pediatrics has been done in a way that is unprofessional and underhanded for the following reasons:

1) There was no consultation with the faculty concerning the decision whether or not to close the department prior to the announcement of the decision.

2) The program has solid academic credentials so that the decision to close the program and department was not based on an academic rationale, i.e. the program is nationally accredited.

3) There was no offer to relocate the faculty as faculty within the university system.

4) Faculty were not offered recourse to establish university grievance procedures.

In addition, it was very wrong to assume that the elimination of the academic Department of Pediatrics will not in any way affect the university's mission to provide a complete education of its students. As the program director of the Pediatric Clerkship Program, this action eliminates the ability to provide a structured pediatric rotation for all medical students who would like to come to our institution for this specialty. Also, if it is assumed that all other residency program residents will only need the clinical experience they are required for residency requirements, there is still a need for faculty to provide the guidance they will need to make sense of their clinical experience.

I join my fellow faculty members in submitting this grievance for your consideration.


Sincerely,

Myrna Pablo, M.D.
Director Pediatric Clerkship Program




Document 9


February 24, 2000

To Whom It May Concern:

When I came to the University of Tennessee, it was for the purpose of establishing a Pediatric Residency Program. In 1993, the ACGME (Accreditation Council for Graduate Medical Education) approved our application. Our first class began July 1, 1994. In 1996 the program underwent a routine site visit and received full accreditation for five years (the maximum given to pediatric residencies). Since the inception of the program we have been successful in attracting quality residents. All of our graduates have been able to find pediatric practices in communities of their choice or have gone on to prestigious fellowships for post graduate training. This year, two of our residents were selected to present posters at national meetings. Ninety-two percent of our graduates are board certified. This number is well above the Residency Review Committee requirements. So it was with much surprise and great dismay that on January 26, 2000 I learned the program would be discontinued June 30, 2001.

I was not consulted concerning this decision to discontinue the program. I was not given a chance to discuss options that could have been pursued to maintain a viable program. I was not asked what were the minimum faculty and educational requirements needed to be fully accredited.

At the January 26, 2000 meeting we were told that when the residency was terminated the pediatric academic department would also be disbanded. There was no discussion of alternative faculty opportunities. We were told we would receive letters confirming the termination of our employment. We were not offered recourse to established university grievance procedures.

This decision has wreaked havoc and hardship on our residents as well as faculty. Since the target date for terminating the residency is June 30, 2001, six first year residents are presently searching for the few second year positions available in the country. This has had a deleterious effect on their work and learning. Also, faculty approaching the end of their careers are now faced with the task of finding alternative employment and probable re-location.

It is obvious that this move to close the program has had a substantial psychological and potential financial impact on residents and faculty. It is particularly disturbing that the faculty was not included in the decision making process.


Sincerely yours,

Patricia Mohr, M.D.
Associate Professor Pediatrics
Pediatric Residency Program Director




Document 10


February 25th, 2000

To whom it may concern:

I have been a full time faculty member with the Department of Pediatrics at the University of Tennessee for the last ten years. I was granted tenure four years ago. On January 26, 2000, I was informed that the department would be closing as of June 30, 2001.

This decision was not consulted with anybody in the department and no input was taken about it from anybody as to what other options there could be.

Academically the department is in good standings, and it is fully accredited at the national level. Our graduates have all been employed and are serving an important population of children in several parts of the country.

As faculty members, many like me, with Tenure, were not offered any opportunities for relocation within the system as well as any recourse to establish university grievance procedures.

I would appreciate any consideration that can be given to the above facts.


Sincerely yours,

Maricarmen Malagon-Rogers, M.D.
Assistant Professor of Pediatrics and
Director, Pediatric Nephrology




Document 11


February 25, 2000

Dear Dr. Glenn,

I am writing concerning the decision to dissolve the Department of Pediatrics of the University of Tennessee Graduate School of Medical Education. I would like to affirm that, to the best of my knowledge, the following are true:

1. There was no consultation with the faculty concerning the decision to close the department, either before or after the announcement of the decision.

2. The program had been accredited, and there has been no suggestion that the quality of the academic program factored into the decision to close the program.

3. There was no offer to relocate the faculty within the university system. We were bluntly told that, since we were being given 18 months notice, no severance package would be offered.

4. Faculty members were not informed that there was any grievance procedure available.


Sincerely yours,

Deborah Zimo, M.D.
Assistant Professor of Pediatrics




Document 12


February 25, 2000

Dear Dr. Glenn,

I am writing concerning the decision to dissolve the Department of Pediatrics of the University of Tennessee Graduate School of Medical Education. I would like to affirm that, to the best of my knowledge, the following are true:

1. There was no consultation with the faculty concerning the decision to close the department, either before or after the announcement of the decision.

2. The program had been accredited, and there has been no suggestion that the quality of the academic program factored into the decision to close the program.

3. There was no offer to relocate the faculty within the university system. We were bluntly told that, since we were being given 18 months notice, no severance package would be offered.

4. Faculty members were not informed that there was any grievance procedure available.


Sincerely yours,

Camilla A. Jocher, M.D.
Assistant Professor of Pediatrics




Document 13


MEMORANDUM

2/23/00

My name is James Donald Coullahan. I am an assistant professor of pediatrics in the Department of Pediatrics at the Graduate School of Medicine Knoxville, University of Tennessee. I joined this faculty in 1995 after retiring from a thirty-eight year career in the Navy. I joined this faculty after interviews with many of the leaders of the Graduate School of Medicine based on their continued reassurance that the Department was strong, was fully supported, and had a long and bright future ahead. I specifically asked about ten years of faculty work and was told that the Pediatric Department was here to stay.

Therefore, I was stunned when we were told a mouth ago that our Department would be terminated as of July 2001. We had already taken a 25% pay cut in July of 1999 as well as elimination of many benefits (CME funding) unexpectedly and without any input from me. Since that time, our faculty has continued to work hard at maintaining the level of excellence that was validated by our five-year accreditation. There was no hint that a closing was being discussed and no one ever talked to me, a faculty member, about such a plan. On the contrary, since we were told to continue to interview and recruit future students (residents), I assumed that the University recognized our value and importance. Suddenly, in the midst of the time consuming and expensive (for both the University and the prospective student) recruiting process, we were told without any advance warning that we were no longer needed or wanted.

I was also amazed that our department faculty never had the opportunity to review the reasons and preplanning on this decision which seems to have been made without consideration for what our futures will hold. No attempt to reassign us as faculty was discussed. We were told that the decision was final. This was interesting to me because of my long Navy career. We always were kept fully informed by Naval authorities and allowed to exercise grievance procedures when closings or terminations were being contemplated. I always assumed that state and University governments would exercise the same due process.


Sincerely,

James Donald Coullahan, MD
Assistant Professor of Pediatrics




Document 14


February 29, 2000

To Whom it May Concern:

I was very surprised to learn that the Pediatric Residency Program at the University of Tennessee Medical Center at Knoxville would end on June 30, 2001. Furthermore, this ending date would permit the first year pediatric level one residents to complete only 24 of the 36 months of training at this institution. I also understood that the Department of Pediatrics would end at the same time the training program ended.

I am not aware that any consultation with myself or any of the other pediatric faculty at the University of Tennessee Medical Center at Knoxville occurred prior to the announcement of the decision.

I am not aware that the pediatric residency program is on probation or has any deficiency. Therefore, it would have solid academic credentials so that the decision to close the program and department was not based on an academic rationale.

As a full-time faculty member since 1985 with a sub-speciality in pediatric critical care, I have not been a part of any discussion or received any offers to relocate as faculty within the University system. Neither have any discussions occurred to utilize my other degrees and expertise in any other colleges within the university system.

It is my understanding that this was a final decision that involved the dean, the associate dean, and the vice-president for health affairs. Thus any recourse for university grievance procedures did not exist in this particular matter.

I have found it difficult to know my faculty rights. I have been a faculty member for 15 years and just discovered after the meeting this January that a faculty handbook existed and that it had been available in the dean's office.


Sincerely yours,

Melinda A. Lucas, M.S., M.D., F.A.A.P.
Assistant Professor of Pediatrics




Document 15


February 29, 2000

Professor Bob Glenn
Chair
Faculty Affairs Committee
University of Tennessee
Knoxville, TN 37920

Dear Dr. Glenn:

This letter is to voice my concern over the decision to close down the Department of Pediatrics at the Graduate School of Biomedical Sciences. At a meeting convened on January 26 by Dr. Michael Caudle and Mr. William Rice, Vice President of Health Affairs at the Memphis campus, the faculty and chairman of the Pediatrics Department, Dr. Eddie Moore, were informed that the Department would be terminated as of July 1, 2001. I am not aware of any discussions or prior information given the faculty of this impending action. The reason(s) offered appeared to be nebulous and without any apparent financial consideration since it was stated that a financial exigency did not exist.

Among the responses given to questions raised by the faculty, it was revealed that tenured members would also be summarily dismissed, i.e. lose their positions without any attempt by the University to offer them relocation within the University or at the minimum to offer some semblance of severance pay. As a tenured faculty member who left a tenured position from the University of South Florida Pediatrics Department (St. Petersburg, FL) in 1992 to join the University of Tennessee as a research scientist in the Pediatrics Department I am very distressed in the manner in which this action was taken and at the apparent lack of any professional ethics on the part of the University. I certainly know of no academic shortcomings of the Pediatric faculty which would warrant any consideration of a departmental closure let alone the execution of this step.

I would request that your office explore the circumstances leading to this decision and let us know whether Pediatric faculty members have any 'due process' within their province as established by guidelines of the University and the American Association of University Professors.


Sincerely,

N. Gengozian, Ph.D.
Professor




Document 16


February 28,2000

Jon P. Coddington, Ph. D.
AAUP Chapter President
College of Architecture and Design
1715 Volunteer Boulevard
Knoxville, TN 37996-2400

Dear Dr. Coddington,

I am writing to thank you for your interest in the plight of the faculty at the University of Tennessee Graduate School of Medicine. I have served on the faculty of the University of Tennessee, on both campuses, for over eighteen years. I am a tenured faculty member and carry the rank of full professor in the Department of Pediatrics. I am a member of the American Association of University Professors. I am asking that you draw to the attention of the national organization the violations of due process which have occurred in the decision to close a fully accredited residency training program in pediatrics and to also close a long-standing academic department of pediatrics which houses approximately thirty faculty.

In a recent meeting of the department, Vice-President for Medical Affairs, Bill Rice, the Dean of the Graduate School of Medicine, Michael Caudle, M.D., and the Associate Dean, Jim Neutons, Ph. D., announced that the decision bad been made to close both the residency program and the department in June, 2001. This announcement shocked the faculty, who had thought we were being called to the meeting to announce an integrated program with nearby East Tennessee Children's Hospital. The closing of the residency program and the department in the year 2001 does not permit those first year residents in the program to complete their three year training.

Needless to say, in violation of the university faculty handbook and national AAUP guidelines, there was absolutely no consultation with the faculty before the decision was made or announced as to whether or not to close the department or the residency program. The departmental chairman stated in the meeting that he was not expecting for the department or the residency program to be closed and had no foreknowledge of this decision other than thirty minutes before the general meeting.

The pediatric primary care-oriented residency training program has received full accreditation for five years from the American Council of Graduate Medical Education, the national review agency for all residency programs in medicine. What I find even more astounding is that in this era when primary care is emphasized and the most lucrative arena of reimbursement in medical education is primary care, our program is being closed. I can discern absolutely no educational reason for doing so.

The meeting was begun by Dr. Caudle and Mr. Rice telling us that the closing was due to the financial problems in academic medicine. However, when I asked if the Board of Trustees had declared the necessary state of financial exigency, Mr. Rice replied that they had not, although he stated they approved the decision. He then stated well, it was really not for financial reasons; it was because there were other residency programs in the state. Again, we have a strong program here and primary care is an emphasized area nationally. It is difficult to believe, especially since the majority of the discussion concerned money, that this was not the basis of the decision. Nevertheless, the faculty were not informed why OUR strong program was chosen for termination rather than at least one weaker one I know of which is on probation. If there were problems, we weren't given an opportunity to solve them. Again, no consultation with faculty occurred.

With regard to the faculty, at no time before, then, or since has anyone approached me about alternative academic placement although I am qualified to teach in several other academic departments of the graduate school of medicine. There was no offer at the meeting to relocate faculty within the university system. The university's teaching hospital has been leased to a private group last summer and some of our faculty may choose to give up their academic careers and seek employment through the auspices of the hospital. However, even this possibility was not addressed.

There was no hint of nor information given concerning university grievance procedures as part of this meeting or thereafter.

With regard to the pediatric residents who moved to this area, one or two of which brought spouses and bought homes planning on staying in this community throughout residency training and thereafter, they were told in the meeting by Mr. Rice that the university system could absorb them in the remaining programs in Memphis or Chattanooga. When the residents called these programs the next day, they were told that Mr. Rice had just slashed one million dollars from the pediatric teaching hospital, LeBonheur's budget and that they would not be taking on any new residents. Chattanooga's program also held out no hope. Thus, the promised help did not come to these trainees in any form. As a faculty member I feel abashed that I engaged actively, both as faculty member and Associate Program Director, in the process of recruiting these residents only to have them devastated by the unexpected and untimely closing of the program. One of the residents broke down and sobbed throughout the meeting which took place with them immediately after the faculty meeting.

In closing, I should like to say that I feel this process demonstrates a wholesale lack of respect for the faculty and trainees and for the "rule of law" as intended in promulgating rules, regulations, and guidelines as published in the faculty handbook which mirrors those proposed by the national AAUP. I am most concerned that this violation of guidelines is not new and may represent only the beginning of a continuing process at the university. I ask your immediate action in bringing this matter to the attention of the national AAUP. Thank you in advance for your attention and cooperation.


Sincerely,

Sandra Loucks, Ph. D., ABPP
Professor and Director,
Division of Behavioral-Developmental Pediatrics


cc:   Mary Papke, Ph.D.
    President, UT Faculty Senate
Bob Glenn, Ph.D.
    President-Elect, UT Faculty Senate





Document 18

UT students may face 5% tuition hike

Knoxville News-Sentinel, February 8, 2000

By Add Seymour Jr., News-Sentinel staff writer

University of Tennessee students could be facing a 5 percent hike in their tuition next year, Provost John Peters told the UT Faculty Senate Monday.

But just after Peters left the meeting, the group passed a resolution that sharply criticized the university's handling of the phasing out of its pediatric residency program.

Peters updated faculty on the university's restructuring plans announced last week during the UT Board of Trustees meeting.

He also outlined parts of Gov. Don Sundquist's proposed state budget that calls for an average faculty salary increase of 6 percent that he said would be implemented, "hopefully, by July 1, 2000."

But Peters added that the budget included an across-the-board 3 percent nonfaculty wage increase that would go into effect by July 1, 2000.

Yet, even as the proposed budget increases UT's funding by $62 million, only $53 million will come in a state appropriation. Most of the rest, roughly $7.5 million, will come from a 5 percent tuition increase.

"I have to indicate that that has only been plugged in for planning," Peters said. "The (UT) trustees will make their determination of this later on because they are the ones that set these fees.

"You have to build the budget on some assumptions. It could be more; it could be less."

The budget is only a proposed one and hinges on the governor's tax plan. But in case that isn't passed and his higher education budget proposals aren't funded, Peters said departments are planning for no budget increases at all.

Peters left a few minutes later, just as Dr. Sandra Loucks, a professor of behavioral pediatrics, criticized the administration's closing of UT's Pediatric Residency program.

"We were that told the closure was brought forth by financial reasons, although no formal declaration of the state of financial situation was made," she said.

Loucks questioned the university's commitment to the faculty and residents of the three-year program who are now forced to find another place to finish their training.

The Senate passed a resolution that asked for the program's June 2001 phase-out to be postponed. The resolution also called the move a violation of due process in the termination of a program.

"Clearly, there's a problem with the manner this has been handled," said Faculty Senate President Mary Papke.

Add Seymour Jr. can be reached at 865-342-6312 or seymourA@knews.com.




Document 19

February 8, 2000

J. Wade Gilley, President
800 Andy Holt Tower
CAMPUS 0180

Dear President Gilley:

At the meeting of the UT Faculty Senate on February 7, 2000, the following resolution was approved unanimously:
Resolved, That the UT Faculty Senate deplores the process used to discontinue the Department of Pediatrics at UT Medical Hospital and urges that the decision be rescinded in order to permit adequate consultation with the faculty of the Department concerning:
   (1) Whether there is an educational basis for the decision;
   (2) Whether there are alternatives to closing the Department;
   (3) Whether there are possibilities for retraining or relocating the faculty in the Department; and
   (4) How the current residents in pediatrics can complete their programs without interruption.
The resolution was based on concern that the decision to discontinue the pediatrics program violated both the University's own procedures and the generally-accepted standards for situations of this kind as they are stated in policy documents of the American Association of University Professors.

I am enclosing the pertinent section from the AAUP statement on "Recommended Institutional Regulations on Academic Freedom and Tenure," whose central provisions are as follows:
(1) The decision to discontinue a program should be determined primarily by the faculty.
(2) The decision to discontinue a program should be based essentially upon educational considerations.
(3) The affected faculty members should be relocated or retrained when feasible.
(4) The affected faculty members should be able to appeal a relocation or termination to a faculty grievance committee.
Also, UT policy on tenure has two similar provisions. The policy as stated by the Trustees in 1998 requires appropriate consultation with the faculty when considering dismissal of tenured faculty and requires that affected faculty be relocated when feasible (see the text reprinted below). And the Faculty Handbook states that "The most direct responsibility of the faculty in University governance is to determine the shape of the academic programs, all of which must be approved by vote of the Faculty Senate ..." (Handbook, 1.7-22).

At a time when the University of Tennessee aspires to be one of the top 25 public universities in the country and cites its governance structure as one of its principal strengths, the Faculty Senate believes that it will serve the institution's goal of promoting excellence to follow established decision-making procedures. Rescinding the discontinuation decision will mean that the students whom we admitted to residencies in pediatrics will be able to complete their programs, faculty whom we have entrusted with direction of a major academic program will participate in decisions about its future, and the University will demonstrate to the nation that we believe in and practice the democratic ideals that are essential to the academy.

I thank you in advance for your serious consideration of this important matter.

Sincerely yours,

Mary E. Papke
President, Faculty Senate
  Robert W. Glenn
President-Elect, Faculty Senate

Enclosure



Document 19b

AAUP Policy Documents & Reports, 1995 edition, p. 25.

Discontinuance of Program or Department Not Mandated by Financial Exigency

(d) Termination of an appointment with continuous tenure, or of a probationary or special appointment before the end of the specified term, may occur as a result of bona fide formal discontinuance of a program or department of instruction. The following standards and procedures will apply.
(1) The decision to discontinue formally a program or department of instruction will be based essentially upon educational considerations, as determined primarily by the faculty as a whole or an appropriate committee thereof.
[NOTE: "Educational considerations" do not include cyclical or temporary variations in enrollment. They must reflect long-range judgments that the educational mission of the institution as a whole will be enhanced by the discontinuance.]
(2) Before the administration issues notice to a faculty member of its intention to terminate an appointment because of formal discontinuance of a program or department of instruction, the institution will make every effort to place the faculty member concerned in another suitable position. If placement in another position would be facilitated by a reasonable period of training, financial and other support for such training will be proffered. If no position is available within the institution, with or without retraining, the faculty member's appointment then may be terminated, but only with provision for severance salary equitably adjusted to the faculty member's length of past and potential service.
[NOTE: When an institution proposes to discontinue a program or department of instruction, it should plan to bear the costs of relocating, training, or otherwise compensating faculty members adversely affected.]
(3) A faculty member may appeal a proposed relocation or termination resulting from a discontinuance and has a right to a full hearing before a faculty committee. The hearing need not conform in all respects with a proceeding conducted pursuant to Regulation 5, but the essentials of an on-the-record adjudicative hearing will be observed. The issues in such a hearing may include the institution's failure to satisfy any of the conditions specified in Regulation 4(d). In such a hearing a faculty determination that a program or department is to be discontinued will be considered presumptively valid, but the burden of proof on other issues will rest on the administration.


UT Trustees Policy on Tenure, June 1998
(http://web.utk.edu/~senate/UT_Tenure6-98.html#10)

"Extraordinary circumstances warranting termination of tenure may involve either financial exigency or academic program discontinuance.... In the case of academic program discontinuance, the termination of tenured faculty may take place only after consultation with the faculty through appropriate committees of the department, the college, and the Faculty Senate.

"If termination of tenured faculty positions becomes necessary because of financial exigency or academic program discontinuance, the campus administration shall attempt to place each displaced tenured faculty member in another suitable position."




Document 20


February 7, 2000

President J. Wade Gilley
800 Andy Holt Tower
CAMPUS

Dear President Gilley,

Any time a department is closed at this University it is a matter of great concern to our academic community. The reported closing of the Department of Pediatrics at the University of Tennessee's Graduate School of Bio Medical Sciences is no exception.

From the Knoxville News Sentinel account of January 31, 2000, it appears that students will be adversely affected. Students who are now in their first year of residency will not be allowed to complete their program at the hospital. The choice of residency is one of the most important educational decisions made by a medical student, and as such the academy has certain obligations regarding this decision. Indeed, anytime students and their academic programs are affected so profoundly and adversely, it is essential that faculty become engaged in the decision making process. This is why the University of Tennessee faculty handbooks on the Knoxville and Memphis campuses as well as the AAUP Redbook identify principles and outline procedures regarding department closings when financial exigency has not been declared. The principle is simple and time honored: because teaching and the curriculum are the responsibility of the faculty, curricular decisions such as the closing of a department must be made in consultation with the faculty. I have including the passages from the handbooks and Redbook which affirm this principle and address the procedures our academic community is to take regarding this matter. It is important to note that these passages are not only designed to protect the integrity of our academic programs, but they also address the rights of tenured faculty affected by such closings. As we understand it, there are a number of tenured faculty affected by this decision.

With the information we now have, it does not appear that the principles or procedures as outlined in the attached documents have been followed. The closing of academic programs and the revocation of tenure are profoundly serious matters which have been raised by this decision. Our entire community including the Faculty Senate needs to become fully involved with both the educational and tenure issues related to the closing.

On behalf of the faculty, the AAUP is turning to you and your staff for clarification as to the basis on which the decision was made and what procedures were followed. I look forward to hearing from you as soon as possible since student and faculty careers and livelihoods have been affected by these administrative decisions.


Sincerely,

Jon P. Coddington
AAUP Chapter President

:kel


Cc:   Professor Sandra Loucks, Department of Pediatrics
Professor Mary Papke, Faculty Senate President
Professor Bob Glenn, Chair, Faculty Affairs Committee
Mary Burgan, AAUP General Secretary





Document 21


To: mkahn@utmem.edu, akang@utmem.edu, dgreenhill@utmem.edu
From: Bob Glenn
Subject: UT Pediatrics Department
Cc: loucks@utkux.utcc.utk.edu

Dear Drs. Kahn, Kang, and Greenhill:

The Faculty Senate at UTK is disturbed by the decision to dissolve the Pediatrics Department at UT Medical Hospital, Knoxville. The decision was made without consulting the tenured faculty in the department, was made apparently for financial and not educational reasons, and did not follow UT's requirements for relocation of faculty and for access to grievance procedures. And of course we are disturbed also by the treatment of the residents, esp. the first-year residents who were recruited to come to UT and have now been told that they will need to go elsewhere to complete their training.

At the Faculty Senate meeting on February 7, the following resolution was approved unanimously:

Resolved, That the UT Faculty Senate deplores the process used to discontinue the Department of Pediatrics at UT Medical Hospital and urges that the decision be rescinded in order to permit adequate consultation with the faculty of the Department concerning:
(1) Whether there is an educational basis for the decision;
(2) Whether there are alternatives to closing the Department;
(3) Whether there are possibilities for retraining or relocating the faculty in the Department; and
(4) How the current residents in pediatrics can complete their programs without interruption.

To date there has been no response from the administration, apart from a statement by President Gilley that he will ask Dr. Rice to reply. In the meantime, at least three of the faculty members have already made commitments to other institutions and undoubtedly many of the residents have decided to leave, too. So it may already be too late to save the Department.

I am writing to ask whether there was any consultation with the UTM Faculty Senate concerning this decision. I don't see any mention of the matter in the minutes for your February 8 meeting. Was it discussed earlier? Were any of the Senate officers involved in the decision? Does the UTM Faculty Senate plan to take a position on the decision to close the Department?

We are preparing a request for examination of the decision by the national staff of AAUP, and it would help to complete the presentation to be able to describe the involvement of faculty at UTM.

I'll appreciate any information you can provide.

Sincerely,

Robert W. Glenn
President-Elect, UTK Faculty Senate
865-974-1923 (w)
865-481-3310 (h)




Document 22

Date: Thu, 24 Feb 2000 09:42:05 -0600
To: glenn@utk.edu
From: Charles Leffler
Subject: Re: FWD: UT Pediatrics Department

First I've heard about it. The Memphis Faculty Senate was neither involved nor informed. I'll try to find out if Bill Rice has anything to add.
Charlie




Document 23

Date: Thu, 24 Feb 2000 08:42:59 -0600 (CST)
From: Andrew H Kang
Subject: RE: UT Pediatrics Department
To: Leffler charles , glenn@utk.edu

Dear Dr. Glenn,

I am not aware of any discussion of the matter at UT Memphis Faculty Senate. However, there is a small chance that such discussions may have taken place in my absence. Therefore, I will ask Dr. Charles Leffler who is the current president of the UT Memphis Faculty Senate.

A H Kang, M. D.
President Elect




Document 24

Date: Thu, 24 Feb 2000 11:05:58 -0600 (CST)
From: E Greenhill
Subject: RE: UT Pediatrics Department
To: glenn@utk.edu
Cc: CLeffler@physio1.utmem.edu

As Past-President I am not aware of the action taken. I will forward your message to Dr. Charles Leffler, President. Why was this department situation brought to the Knoxville campus senate when they are a part of the Memphis campus faculty?




Document 26

Date: Tue, 29 Feb 2000 09:28:26 -0600
To: glenn@mailhost.cas.utk.edu
From: Charles Leffler
Subject: Grad Sch Med, Pediatrics

Bob,

In relation to our e-mail correspondence of last week, Bill Rice met with the Executive Committee of the Faculty senate and the standing committee chairs to discuss the plans for closing the Department of Pediatrics in Knoxville in the summer of 2001. I wanted to have not only the Executive Committee but also the committee chairs to increase the number of Senators involved.

He indicated that a primary reason for discontinuing this department involved the very low patient population (average census of six in University Hospital last year), that is largely the result of inability over the last 20 years of trying to develop an affiliation with the children's hospital in Knoxville. The action had to be initiated now due to the yearly match (to phase out the residency). Consultations have been ongoing since last fall with the department and the college. Mr. Rice indicated that although very disappointed the departmental faculty should not have been surprised.

The extensive effort at present is to first place the current first year residents in other programs and second to find positions for the tenured faculty of the department. According to our handbook the only required consultations with faculty senate would be if a tenured faculty member was terminated due to elimination of a department. We hope that situation does not arise.

The questions of the Executive Committee and committee chairs centered around reactions of the departmental faculty, opinions of the Dean of the College and the Department Chair, relocation of first year residents, difficulties that might face the last class of residents, and plans for relocation of current faculty. No one could disagree that on both academic and financial grounds the patient population is inadequate for a viable residency program.

Charlie

Charles W. Leffler, Ph.D.
Professor, Departments of Physiology and Pediatrics
Director, Laboratory for Research in Neonatal Physiology
University of Tennessee, Memphis
Memphis, TN

cleffler@physio1.utmem.edu
(please note that's "@physio'one'" not "@physiol")

fax 901-448-7126




Document 27

Governance and Academic Programs

Faculty Handbook, UT-Memphis

http://www.utmem.edu/facsenate/handbook.html

Approved by The University of Tennessee Board of Trustees at its meeting 17 June 1999.


http://www.utmem.edu/facsenate/newsection2.html


2.2 Academic Governance of The University

Document 27a

2.2.1 The Role of the Board

The Board is the final institutional authority on academic policy. The Board may establish or revise University policy on any academic matter other than the planning and development of the curricula. The University's Charter and Bylaws specifically reserve to the Board the authority to:
a. establish admission, progression, and retention requirements for students;

b. confer academic degrees;

c. determine new or revised programs to be offered relating to instruction, research, and service;

d. grant tenure;

e. approve the establishment of all major academic units, i.e., campuses, colleges, departments, institutes, etc.; and

f. approve the adoption and revision of faculty personnel policies.

2.2.3 The Role of the University Faculties

The faculties of the various University campuses and institutes have, for their respective units, the specifically reserved and sole authority to plan and develop the curricula (Section 2.3.7.1). Furthermore, the faculties must authorize The University to award academic degrees, and must actively participate in the determination of the strategic directions of the campuses and institutes of The University.


2.3 Academic Governance of UT Memphis

2.3.1 General Policy

Effective academic governance is a hallmark of a mature educational institution. Therefore, all participants have the duty to strive to make academic governance at UT Memphis:
a. a cooperative process that demands a joint effort between the Chancellor and the Faculty of UT Memphis with appropriate participation by students, alumni, and staff;

b. an open process that is characterized by a courteous, free-flowing exchange of information and opinions between all interested parties;

c. a respectful process that gives increased weight to the opinions of participants who are accountable for the matters under consideration;

d. a comprehensive process that assumes that any issue may be relevant to the academic enterprise;

e. a bilateral process that produces (1) policies that are campus-wide in their applications, and (2) policies that only apply to one college or non-collegiate academic unit; and

f. a responsible process that is subordinate to governmental authority, the final institutional authority of the Board, and the delegated authority of the President.




Document 28

Termination of Tenured Faculty

Faculty Handbook, UT-Memphis

http://www.utmem.edu/facsenate/handbook.html

Approved by The University of Tennessee Board of Trustees at its meeting 17 June 1999.


http://www.utmem.edu/facsenate/newsection7.html


7.1.3 Termination of a Tenured Faculty Member's Appointment Due to Extraordinary Circumstances

Extraordinary circumstances warranting termination of tenure may involve either financial exigency or academic program discontinuance. Under such circumstances, termination of a faculty member's tenure results in immediate termination of that individual's employment with UT Memphis.

According to the Board's policy, in the case of financial exigency, the criteria and procedures outlined in the Board-approved Financial Exigency Plan for UT Memphis shall be followed. The UT Memphis Financial Exigency Plan is contained in Appendix O. Financial exigencies affecting UT Memphis may require the termination of services of one or more tenured faculty members. In every case of financial exigency resulting in the termination of a tenured faculty appointment, the faculty member concerned will be given notice as soon as possible, and every effort shall be made to give not less than twelve months' notice or twelve months' salary.

According to the Board's policy, in the case of academic program discontinuance, the termination of tenured faculty may take place only after consultation with the Faculty through appropriate committees of the department, the college, and the Faculty Senate. When termination of a tenured faculty appointment is based upon discontinuance of a program or function at UT Memphis, the Administration shall seek appropriate faculty discussion in arriving at such decisions, unless this decision is made by an authority outside The University, and shall exert every effort to make suitable reassignments of personnel. In every case of discontinuance of a program or department of instruction, resulting in termination of appointment, the tenured faculty member concerned will be given notice as soon as possible, and never less than twelve months' notice or twelve months' salary.

According to the Board's policy, if termination of tenured faculty positions becomes necessary because of financial exigency or academic program discontinuance, the UT Memphis Administration shall attempt to place each displaced tenured faculty member in another suitable position. This does not require that a faculty member be placed in a position for which he or she is not qualified, that a new position be created where no need exists, or that a faculty member (tenured or non-tenured) in another department be terminated in order to provide a vacancy for a displaced tenured faculty member. The position of any tenured faculty member displaced because of financial exigency or academic program discontinuance shall not be filled within three years, unless the displaced faculty member has been offered reinstatement and a reasonable time in which to accept or decline the offer.




Document 29

POLICIES GOVERNING
ACADEMIC FREEDOM, RESPONSIBILITY, AND TENURE


Approved by the UT Board of Trustees at its meeting of 18 June 1998

http://web.utk.edu/~senate/UT_Tenure6-98.html#10


H. Termination of Tenure
1. Grounds for Termination
(a) Relinquishment or Forfeiture of Tenure
A tenured faculty member relinquishes tenure upon resignation or retirement from The University. A tenured faculty member forfeits tenure upon taking an unauthorized leave of absence or failing to resume the duties of his or her position following an approved leave of absence. Forfeiture results in automatic termination of employment. The chief academic officer shall give the faculty member written notice of the forfeiture of tenure and termination of employment.
(b) Extraordinary Circumstances
Extraordinary circumstances warranting termination of tenure may involve either financial exigency or academic program discontinuance. In the case of financial exigency, the criteria and procedures outlined in the Board-approved Financial Exigency Plan for each campus shall be followed. In the case of academic program discontinuance, the termination of tenured faculty may take place only after consultation with the faculty through appropriate committees of the department, the college, and the Faculty Senate.

If termination of tenured faculty positions becomes necessary because of financial exigency or academic program discontinuance, the campus administration shall attempt to place each displaced tenured faculty member in another suitable position. This does not require that a faculty member be placed in a position for which he or she is not qualified, that a new position be created where no need exists, or that a faculty member (tenured or non-tenured) in another department be terminated in order to provide a vacancy for a displaced tenured faculty member. The position of any tenured faculty member displaced because of financial exigency or academic program discontinuance shall not be filled within three years, unless the displaced faculty member has been offered reinstatement and a reasonable time in which to accept or decline the offer.



Document 30

February 29, 1999

MEMORANDUM

To:   John P. Coddington, AAUP Chapter President
Mary Papke, Faculty Senate President
From:   Bill Rice
Subject:   Department of Pediatrics, Graduate School of Medicine
Knoxville Memorial Hospital

Thank you for your recent communication relating to the discontinuance of the Department of Pediatrics in Knoxville. This is to inform you that we have followed the appropriate procedures for the discontinuance of an academic program as detailed in our Faculty Handbook. We are fully committed to assist all our residents to complete their training and to attempt to place each displaced tenured faculty member in another suitable position, if possible.

We encourage all faculty of the Graduate School of Medicine in Knoxville who wish to discuss this matter further to consult with Dr. Charles Leffler, President of The University of Tennessee Health Science Center Faculty Senate.

We thank you for your interest in this matter.

WRR:02292000/jmm

cc:   J. Wade Gilley, President, The University of Tennessee
Charles Leffler, President, Faculty Senate, UT Health Science Center
R. A. Palazzolo, Chief Academic Officer





Document 31

[Contemporaneous notes by Professor Sandra Loucks, January 26, 2000.]

NOTES ON MEETING WITH RICE, CAUDLE, NEUTONS
ENDING OF DEPARTMENT & RESIDENCY


1. Met on January 26 in library conference room--most of faculty, Lozzio, Eddie & Pat met with them first, thirty minutes before.

2. Couldn't read Pat's face.

3. Rice introduces self. Caudle "feels pain" -- announced financial problems in medical education and the state; graduate school of medicine cut off with little money, Tenncare, Medicare may cut

4. Caudle -- closing down residency and department, July1, 2001

5. Stunned faculty -- couldn't believe closing of department -- couldn't believe not letting all residents finish

6. Few of us spoke up through our shock: Me to Bill -- Did the Board of Trustees declare financial exigency? He said -- no, but I took this to them & they approved. Me -- if the reason's financial, then state of exigency needed. Well it's also we have too many programs in state. ?????

7. Me -- if the problem is financial have you given thought to sharing of revenues between departments? They seemed to think this ridiculous. Answer -- impossible.

8. Eddie Moore only spoke to deny knowing anything about the closing of the residency or department and said he hadn't prepped us. "How could you since you didn't know?" Caudle

9. Gaylord -- you're making a big mistake. You're really hurting the medical care of children in this region. People will think you're closing all the pediatric services in the hospital as well.

10. Metz -- I'm worried about what you're doing to the residents. What will happen to the first year residents? You'll impair the training of the supervising residents who won't have first year residents to supervise. Rice and Caudle -- we'll help them find other programs. If they can't they can stay; we'll work something out. They should really go, though. Brought up our spending money, time, and effort this year recruiting new residents. Medical students spent their money coming here on interviews. Why do this so late?

11. Zimo angry at this timing and decision. Hard to understand it.

12. Them -- the decision is final. The department will be closed and the residency with it.




Document 32

Date: Sat, 4 Mar 2000 17:49:58 -0500
From: Deborah Zimo
To: sloucks@utk.edu
Subject: meeting report

Sandra,

The following information covers what I remember of the meeting at which we were informed that the pediatric residency would be dissolved.

We were informed on Monday 1/24 that there would be a meeting of the pediatric faculty with Dean Caudle on Wednesday 1/26. Dr. Caudle, Dr. Newtens, and Mr. Rice represented the administration at the meeting, which lasted about 50 minutes.

After introducing Dr. Newtens and Mr. Rice, Dr. Caudle began by describing his dismay at being the messenger of the news that he had to impart. He reviewed the devastating impact that the cutbacks in funding for medical education stemming from the Balanced Budget Act have had on the graduate school of medical education and on the hospital. He then announced that, as a result of the crisis in funding for graduate medical education, the decision had been made to terminate the pediatric residency program and the department of pediatrics as of June 30, 2001. Since some residents would not have completed their training by that time, they would be assisted in finding alternative programs at which they could complete their residencies. He then agreed to try to answer any questions.

Dr. Mark Anderson asked what would happen to our vacation and sick days, noting that he had enough accumulated to enable him to take off from now until June 2001. Dr. Caudle didn't know. Dr. Newtens said that that information could be obtained from his office. Later in the meeting when this question resurfaced, Dr. Newtens offered to have this information compiled for all the faculty, rather than each of us requesting it individually. (The faculty unanimously agreed that this was a good idea, but I have received no information to date.)

Dr. Malagon asked what would happen to the faculty. Dr. Caudle reiterated that the department of pediatrics would no longer exist, nor would faculty salaries, as of June 2001. Faculty members who were unable to "live" off clinical earnings would need to find positions elsewhere. No severence package would be offered the faculty because of the long notice.

Dr. Loucks asked about the tenured faculty. Dr. Caudle said that, since the faculty were tenured to the department and the department would no longer exist, tenured faculty would have no position. Dr. Loucks then asked about the legality of dissolving a faculty (tenured faculty?) when there was not a situation of financial exigency. Mr. Rice or Dr. Newtens agreed that there was not a situation of financial exigency, but stated that they were still able to pursue the intended course. I didn't understand this discussion.

I asked about the delayed timing of this announcement, given that rumors of the demise of the department had been rampant 4 months earlier and that we had been actively recruiting interns for next year. Mr. Rice responded, saying that they had wanted to explore every avenue before concluding that there was no recourse but to eliminate the pediatric residency and department. He said that the announcement was being made now, before 4th year medical students turned in their MATCH rankings. He did not respond further to my comment on the time, energy, and expense that had already been wasted in recruiting efforts during the preceding months.

Someone asked if any other departments/programs were going to be eliminated. We were told that pediatrics was the only department/program to be eliminated now, but that others were in financial straits also and might have to be eliminated in the future.

Someone asked what would happen if all the residents left before 6/200l, and we were assured that the department would continue until 6/2001 no matter what.

The bulk of the remaining discussion, as I recall, was Dr. Gaylord's discourse on the adverse effect/bad PR this would have on the hospital within the community. The only response that I remember was one indicating that the decision was final, no longer subject for debate, and that they would have to deal with any concern within the community.

No mention was ever made in any of this discussion that suggested that the quality of the pediatric program was a factor in the decision to eliminate it. The only factors mentioned were financial/economic.

Deborah Zimo


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